In a study conducted by the World Health Organization (2001), it found that France has the best overall health care system among the 191 countries surveyed while the United States placed only 37th (Paul V. Dutton, 2002, p.2). One of the reasons for the ranking is that a large number of Americans still do not have health insurance which is estimated at 50 million. The second reason is that despite the lack of coverage, the United States still spends the most on its health care at 13.7% of GDP (Paul V. Dutton, 2002, p.2). Needless to say, it is a unanimous view that America’s health care system needs to be reformed. What these changes will be and how will these changes be implemented is a matter of significant dissension among many lawmakers and other interest groups.
Presently, there are three major bills that are being debated in the Senate Finance Committee, the Senate Health Committee and the House Committee. While there are significant differences, these three bills have the same objective of reforming America’s health care system. One of the features of these bills is that they seek to make access to health insurance universal (“Reforming Health Care Reform,” 2008, p.1). Access to a universal health care system has long been the dream of many Americans. Many Americans have lobbied for it. Under these bills nearly everyone are required to have health insurance that will protect them against rising cost of health care. The rule is that everyone must have health insurance. There is, however, a concern as to who are exempted from coverage. The Senate Health Committee is proposing that when the premium cost at least 12.5% of their annual income or who are below 150% of the poverty level may be exempted from coverage (Anna Wilde Matthews, 2009, p.1). The Senate Finance Committee, on the other hand, proposes the limit is 10% of the annual income and those who are earning below 133% poverty line (Anna Wilde Matthews, 2009, p.1).
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Another feature under these bills is the penalty clause for those who fail to buy health insurance. At present, there are already some states which impose penalty to those who fail to secure health insurance but are capable of paying for them. If passed, the requirement will be made to apply to everyone regardless of which state he is in. These bills recommend that those who fail to buy health insurance shall be fined by either $750 per person if his income is up to three times the poverty level or up to $950 if his income is more than three times the poverty level (Anna Wilde Matthews, 2009, p.1). There are some who are in favor of the penalty clause. However, there are also some who are against it. Those objecting to this proposal say that this is unjust and unfair to persons who could not afford to pay health insurance. It is their argument that the persons who can least afford to pay health insurance will be penalized for their financial difficulties. They say that the government should not transfer the buck to the people. If the public could not afford to pay for their health insurance it only goes to show that the government has failed in making health insurance available to the public.
One of the suggestions to make health insurance more accessible is for the government to provide subsidy by allowing tax credits to purchase insurance in the individual market. Under the proposed bills, the government is willing to subsidize people who are making up to 400$ of the poverty level or around $73,000 for a family of three (Anna Wilde Matthews, 2009, p.1). The bills however vary on the amount. The Senate Health Committee bill requires that a family of three making $55,000 need to pay $4,300 while the Senate Finance Committee proposes $6,600.
These proposed bills are in line with President Obama’s plan of making health insurance to those who already have it more secure and stable. It is also President Obama’s goal to make health insurance accessible to those who still do not have it. My concern however is that the penalty clause which is part of these bills imposing either $750 or $950 to those who will fail to buy health insurance can be considered a tax increase even if President Obama does not consider it as a tax. This amounts to a middle class tax increase. If this is a tax then it contradicts the promise made by President Obama during his campaign that he will not raise taxes on the middle class or those who earn less than $250,000 a year (Christopher Beam, 2009, p.3)
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